Clomid and AI (w/ low T & low E2)

workoutguy123

New Member
Summary of my lab work:
Okay total T
Low Free T
High SHBG
Low LH
Underperforming Thyroid
Low E2 Estradiol senstive - 7.4 (normal = 8.0 - 35.0)

Doctor has started me on 12.5 Clomid (EOD) and AI (Anastrozole) (3x per week)

From what I gather, the treatment plan lis designed to elevate my free T and LH. I’m curious of the AI, given my already low E2. The doctor said he was prescribing the AI, per elevated estrogen with the Clomid. With the above doses, is the expectation that the clomid will raise my estrogen, but the small dose of AI will suppress it enough to not get to high, and simply elevate to a normal range?

I’m 2.5 weeks into this treatment plan. I don’t feel any difference at this point, but I’m assuming it’s normal not to feel anything this early into it.

My low T symptoms are weight gain/inability to get as lean as I use to & low libido.
Reading more about low E2 symptoms, I’m not sure if the low E2 is the reason or not, but for at least 10 years I’ve felt like I urinate more frequently than anyone I know, and I’m always cracking my joints. I'm woindering if I've always had low E2, and am just finding out now that the low T symptoms urged me to get lab work done. Would be great to see these symptoms improve.

Thanks for insights.
 
Clomid increases SHBG and therefore isn't recommended for high SHBG men, as your SHBG increases, Free T and estrogen will decrease. If you were to increase the clomid dosage and therefore LH, SHBG would increase and cancel out the increase in testosterone and your Free T will remain low.
 
Summary of my lab work:
Okay total T
Low Free T
High SHBG
Low LH
Underperforming Thyroid
Low E2 Estradiol senstive - 7.4 (normal = 8.0 - 35.0)

Doctor has started me on 12.5 Clomid (EOD) and AI (Anastrozole) (3x per week)

From what I gather, the treatment plan lis designed to elevate my free T and LH. I’m curious of the AI, given my already low E2. The doctor said he was prescribing the AI, per elevated estrogen with the Clomid. With the above doses, is the expectation that the clomid will raise my estrogen, but the small dose of AI will suppress it enough to not get to high, and simply elevate to a normal range?

I’m 2.5 weeks into this treatment plan. I don’t feel any difference at this point, but I’m assuming it’s normal not to feel anything this early into it.

My low T symptoms are weight gain/inability to get as lean as I use to & low libido.
Reading more about low E2 symptoms, I’m not sure if the low E2 is the reason or not, but for at least 10 years I’ve felt like I urinate more frequently than anyone I know, and I’m always cracking my joints. I'm woindering if I've always had low E2, and am just finding out now that the low T symptoms urged me to get lab work done. Would be great to see these symptoms improve.

Thanks for insights.

I have been on low dose clomid 12.5mg eod for about a year now and also have low E though unfortunately the country I am in does not do the sensitive E2 test so it a bit vague as to where I sit.

I have found that even extremely low doses of Anastrozole ( 0.1mg twice a week ) crashes my E2 and I end up with very sore joints. If your doc is prescribing Anastrozole 3 times a week and if its the 1mg pills you will be in serious danger of bone loss and other nastiness.

Clomid tends to work very quickly and is often referred to as having a honeymoon period for the first 3 weeks as it quickly raises your T, after a month to 2 months the effects of the Zuclomiphene tend to take over and its at that time that you might need to add a Little AI.
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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